ACA threat­ened by King law­suit

Modern Healthcare - - NEWS - By Lisa Schencker

Op­po­nents of the health­care re­form law tried this year to kill it with a thou­sand le­gal cuts, and one of those at­tacks in par­tic­u­lar may yet prove dis­abling. In Novem­ber, the U.S. Supreme Court un­ex­pect­edly agreed to hear King v. Bur­well, which con­sid­ers whether the lan­guage of the Pa­tient Pro­tec­tion and Af­ford­able Care Act al­lows Americans in states that have not “es­tab­lished” their own in­surance ex­changes to re­ceive fed­eral pre­mium tax cred­its. The Oba­macare op­po­nents who filed the chal­lenge cite one part of the law that says the tax cred­its are avail­able to Americans who en­rolled “through an ex­change es­tab­lished by the state,” which they say means that peo­ple in the 34 to 37 states us­ing the fed­eral ex­change aren’t el­i­gi­ble to re­ceive them. The Obama ad­min­is­tra­tion coun­ters that the law read in its en­tirety au­tho­rizes the sub­si­dies in ev­ery state.

If the high court in­val­i­dates the sub­si­dies, mil­lions of Americans are likely to drop their cov­er­age be­cause it would no longer be af­ford­able. Ex­perts say that would dis­rupt the law’s cov­er­age ex­pan­sion and in­surance re­forms, drive up pre­mi­ums and cre­ate strong po­lit­i­cal pres­sure to roll back or re­peal the en­tire law.

Tim Jost, a law pro­fes­sor at Wash­ing­ton and Lee Univer­sity who sup­ports the re­form law, said that when Repub­li­cans failed in their 2012 con­sti­tu­tional chal­lenge to the law be­fore the Supreme Court, lost the pres­i­den­tial elec­tion that year and failed to re­peal it after dozens of votes in the House, “they de­cided their best shot was to file lots of law­suits.” He is very wor­ried about the King case, which may hinge on the vote of Chief Jus­tice John Roberts, who was sharply crit­i­cized by con­ser­va­tives for up­hold­ing the law in 2012.

The King case may hinge on the vote of Chief Jus­tice John Roberts, who was sharply crit­i­cized by con­ser­va­tives for up­hold­ing the law in 2012.

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